Tag Archives: medical writing

Continuing Medical Education (CME): Role for Medical Writers

By DeeAnn Visk and Nisha Nair

Maimonides, a twelfth century physician, wrote a daily prayer:

“Let the thought never arise that I have

Attained enough knowledge

But vouchsafe to me ever the strength,

The leisure and eagerness to add to what I know

For art is great and the mind of man ever growing.”

This clearly sums up the attitude of physicians toward continuing medical education in a bygone era. With the continuing advances in the field of medicine and diagnostics, practitioners and other health professionals need to remain current on updates regarding recent advances in their field. Most physicians and medical researchers have not had formal training in CME writing.  Therefore, there is an ever-increasing need for medical writers to effectively disseminate knowledge by clearly communicating progress in medicine.  Hence, the NorCal AMWA chapter addressed the need for CME writers during a recent meeting.

Medical practice in medieval times

Introduction to CME as a Medical Writer

The talk was presented by Joshua Schechtel, MD, MPH, FAAP, guest speaker.  Josh is a self-employed consultant with 25 years of experience in the field of CME writing and is currently the Manager of the Medical Education Program for San Mateo County Health. Previously he was the medical director of the Permanente medical group, a member of the editorial advisory board of the New Physician magazine, and has served on the board of the Pacific Horticultural Society for 12 years.  

Josh spoke at length about the theory and practice of CME as it exists today. He also provided an overview of the history of CME in the US and how various regulations have evolved to make the CME industry what it is today. In order to understand the opportunities for medical writers in continuing medical education (CME), it is first necessary to understand some basics about CME.

Water lilies.  Photo by Joshua Schechtel

Conflicts of Interest, Real and Perceived

Josh also outlined the regulations that govern disclosure of conflicts of interest, both technical and financial, of the author, an important step for anyone who makes a foray into the field of CME writing.

One of the most important elements in understanding CME is the importance of disclosures.  Josh began his presentation by noting that he does “not have a financial interest/arrangement or affiliation with any organization that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.”

Any reputable offering of CME must disclose any conflict of interest as well as anything that could be construed as a perceived conflict of interest.  These conflicts of interest range from stock in a company to involvement in clinical trials of a new drug.  Even if the conflict could merely be construed, it must be disclosed.

An example of a perceived conflict can be found in a situation where a practicing psychiatrist was presenting a CME about screening for depression.  The psychiatrist had received grants for drug research from pharmaceutical companies that market drugs for depression. This may not be considered a potential conflict of interest, as the research grant specifically funded treatment for depression and did not fund research for tools used in diagnosis of depression.  Hence, it was fine for this psychiatrist to present a CME on screening for depression, which is considered separate and distinct from treating depression.

Most conflicts of interest do not preclude medical doctors from presenting CME, as long as they are disclosed upfront.  This is analogous to the situation in publishing papers. Authors with conflicts of interest can publish findings; they simply need to disclose real or perceived conflicts of interest.

Embarcadero, San Francisco, CA, near to where the NorCalAMWA meeting was held

Medical Writers Generally Have No Conflicts of Interests

During the question and answer section, the point of medical writers having conflicts of interest arose.  In general, most medical writers will not have a conflict of interest if they have written for a CME organization and want to take work at a different CME entity.

Each State Has a Body to Oversee CME for that Particular State

Another key point was the understanding that the individual states have State Medical Boards that govern the practice of medicine in that state; the State of California was the example used for this meeting.  If writing CME for another state, then refer to the rules for the medical board of that particular state. This is mainly to ensure unbiased information. In some states, the rules are very explicit but in California, the regulations are more implied to ensure transparency.

The California Legislature defines CME as educational activities that meet the standards for the Division of Licensing and serve to maintain, develop or increase the knowledge, skills, and professional performance that physicians or surgeons use to provide care, or improve the quality of care provided for patients, including, but not limited to, educational activities that meet any of the following criteria: 

  1. “Have a scientific or clinical content with a direct bearing on the quality or cost-effective provision of patient care, community or public health, or preventive medicine
  2. Concern quality assurance or improvement, risk management, health facility standards, or the legal aspects of clinical medicine
  3. Concern bioethics or professional ethics
  4. Designed to improve the physician/patient relationship”

The definition expressly excludes: “educational activities that are not directed toward the practice of medicine, or are directed toward the business aspects of medical practice, including, but not limited to, medical office management, billing and coding, and marketing.”

Details of rotunda in the California State Legislature building

What CME is Not

To prevent frivolous offerings of CME, the following are NOT allowed for CME, as they are neither education activities, nor directed towards the practice of medicine:

  1. “Medical office management in integrated healthcare delivery/group practice arrangements
  2. Marketing of integrated delivery systems/group practice arrangements
  3. Understanding corporate structure from a financial or legal perspective”

All CME providers must be accredited to provide CME in a particular state.

Who Accredits Organizations that Offer CME?

Historically, the American Medical Association (AMA) published the Physicians Recognition Award and Credit system and trademarked the term AMA PRA Category 1 CreditTM.  Legislative reform attempt to update and make it current for those practicing medicine

Accredited CME providers may certify nonclinical subjects (such as office management, patient-physician communication).  The line gets rather grey here; several of these subjects may be rather questionable.

The institute for Medical Quality (IMQ)/California Medical Association (CMA) is recognized by the Accreditation Council of Continuing Medical Education.  This means that all organizations wising to offer CME in the State of California, must first be accredited by IMQ/CMA.  Thus, medical writers developing a relationship with CME offering organizations, should check to see if the organization is accredited by IMQ/CMA.

A Brief History of CME in the US

The earliest CME was probably in the 1920’s at the Mayo Clinic.  In 1927 the Bulletin of the Mayo Clinic and the Mayo Foundation began publishing; this publication evolved into the present Mayo Clinic Proceedings.  Before this time, physicians found it difficult to keep current with new practices.

The first medical specialty organization in the US, the American Urological Association, had the first mandatory CME program in 1934.  In 1957, the American Medical Association (AMA) published the first CME guidelines.  By 1968 that evolved into the physician recognition award.  The Accreditation Council for Continuing Medical Education was created in 1981 as a way to lessen AMA’s hold on CME.

In 2007, the Senate Committee on Finance questioned the pharmaceutical industry’s funding of CME for physicians.  This report led to reforms in the system, but constant vigilance is still needed.

Careers in CME Writing

Much CME content is written by medical providers; unfortunately, most clinicians are untrained in the art of medical writing, Nonetheless, they are content experts.  Medical writers contribute to the generation of excellent CME by writing content and editing drafts.  Clinicians and medical writers work together to address the needs of physicians to stay abreast of current medical best practices.  Practicing clinicians are subject matter experts, providing expertise on CME content.  Medical writers ensure the accuracy and readability of CME content from a writing standpoint, with appropriate citations as needed.

Photo taken while traveling from San Francisco to San Diego.  Photo by DeeAnn Visk.

Trends in CME writing

Josh analyzed trends over the past 10 to 12 years, using the ACCME 2017 Data Report

  • Accredited providers reported close to $2.7 B in investment in medical education from a variety of sources in 2017, an increase of 6% from 2016.
  • 44,000 activities for 105,000 hours of interaction, with 6 M physician interaction and millions of other learner interactions; non-physician accounted for about 7.8 M interactions
  • There are about 1800 certified providers offering accredited CME in the US
  • About 163,000 courses are offered for CME nation-wide.
  • 2005 to 2017 witnessed an internet-based CME increased about 7-fold.
  • For non-physicians there was an 8-fold increase from 2006 to 2016.
  • A much larger audience for internet-based materials than print journals was noted.

A quick Google search for “continuing medical education online” returned 500 million results, reinforcing the large number of offerings that are web-based.

Here are a few of the most familiar organizations providing CME:

To find jobs/work/projects for medical writing, places to look include:

Types of CME Writing Assignments

  • Slide decks
  • Monographs or journal supplements
  • Online clinical case studies
  • Video round table discussion, more conversational style
  • Audio or video podcast
  • Newsletters

Visiting Lassen Volcanic National Park does not count as CME.  Photo by DeeAnn Visk.

Questions and Answers

The discussion following the presentations covered a wide range of topics. 

Pharmaceutical companies discover many new and effective drugs.  In order to train specialists to utilize the drugs effectively, the companies may offer CME programs in order to train physicians on how to best to use them.  New approaches may also need a fresh diagnostic approach.  Hence, what can appear to be a blatant conflict of interest, should be considered in the light of educating doctors, who may be unaware of new developments.  Balancing this need for further education with the for-profit motive can be challenging.  Medical writers need to carefully consider this before determining if a conflict of interest exists and while preparing a particular CME proposal.

Additionally, new therapeutic approaches often require the use of diagnostic tests to correctly identify patients for whom the treatment is effective.  Conversely, a diagnostic test may also be used to rule out a specific therapy for patient treatment.  Diagnostic/prognostic tests can include patient questionnaires, blood analytes, genetic sequencing (both somatic and germline), imaging, and staining of tissue sections.  Training doctors to correctly order and interpret the tests for new therapies requires instruction—often in the form of CME.

Another topic of interest was the “needs assessment.”  Basically, this is a rationale for why a particular CME needs to be offered.  The needs assessment usually includes a polling of clinicians, to determine the necessity of preparing CME materials for a specific topic. The national AMWA website offers more insights into writing needs assessments.


In short, writing CME is more of a RIGHT-ing job, defining the need and bridging the gap in an existing specialty. CME writing is all about contributing to healthcare in the WRITE way; it requires conscientious research, precise writing, and devotion to accuracy.  Medical writers are an important part of the team, working towards the goal of informing clinicians on updates to emerging medical treatments through continuing medical education.  Delivering current and intelligible information to clinicians in a timely and non-time-consuming manner is the heart and challenge of continuing medical education.

About the Authors

Nisha Nair, MD

Dr. Nair is a talented medical writer with experience in the field of pharmacovigilance. Her experiences range from literary specialties such as single case processing, aggregate reporting, medical writing, and literature reviews, to industry focuses such as business development, team leadership, and client relationship management. Well versed in regulatory writing, Dr. Nair has conducted clinical trials training workshops for the biopharmaceutical industry and research institutions.  Clients of Dr. Nair include established multinational companies as well as startups.

With proven people management skills, Dr. Nair has organized several successful projects and worked with people at all levels, motivating staff on both individual and team levels.  For more information, contact her at nishanair@pacificsafetygroup.biz and view her LinkedIn page:  https://www.linkedin.com/in/dr-nisha-n-puthiyedath/



DeeAnn Visk, PhD

DeeAnn Visk, PhD, is a San Diego based medical writer.  Pharmacogenetics, high throughput screening, immunohistochemistry, confocal microscopy, and oncology are some of her content area specialties.  Projects Dr. Visk has worked on include:  articles for trade periodicals, editing of manuscripts before submission for peer-editing, writing manuscripts for submission, and informational articles from conferences. As the president of a local non-profit, the Association for Women in Science for two years, Dr. Visk gained experience in managing a 200-plus member organization. An active member of the Clinical Pharmacogenetic Implementation Consortium (CPIC), Dr. Visk was instrumental in the initiation of the Dissemination Working Group within CPIC.

When not researching, writing, or editing, Dr. Visk enjoys hiking and visiting National Parks.  Residing northeast of downtown San Diego, Dr. Visk is married with two kids with two very spoiled hens in her backyard.  For more information on her experience, please read this webpage and visit her LinkedIn profile.  Dr. Visk can be reached at deeannlwv@gmail.com.

how everyone sees SEO differently

Search Engine Optimization for Medical Writers

Demystifying Search Engine Optimization for Medical Writers

Mystery surrounds search engine optimization (SEO).  What is the best way to accomplish SEO?  Pay for Google ads?  Find a shady, off-shore company to click on your site 100,000 times?  Use a consultant?  Plunge into the SEO world on your own? This article will assist content generators to better understand and assist clients with SEO.  As communicators of information, medical writers need to be aware of what works and what does not in writing for the purpose of search engine optimization (SEO).

Having good solid information for readers in the best SEO.

Google considers pages that have “an impact on your current or future well being [sic]” Your Money or Your Life (YMYL) pages.  YMYL pages contain content deemed by Google to have a big impact on your life—obviously medical information falls into this category.  YMYL pages are scrutinized more than non-YMYL pages.

To understand SEO, it is necessary to understand how a Google search works.  Google keeps its computer program, or algorithm for searching the web, a deep, dark secret.   That’s fine; I am not qualified to dissect lines of code—let’s go with broader concepts.  Google web crawls, or looks through the content of web pages.  Web crawling is done automatically, any time of the day or night.  The website needs to be available at all times (no down servers), to keep the web crawlers (called spiders) happy.

how everyone sees search engine optimization differently

SEO humor:  how everyone sees it differently

White Hat vs. Black Hat Methods

As with many things, there are “white hat” and “black hat” methods.  White methods are good, upfront means to build SEO.  Black hat methods are seen as devious and underhanded.   The preferable way to optimize your ranking in a search engine is to develop good, useful content. This is white hat SEO, versus trying to fool the search engines, the black hat approach.

Black Hat Methods to Avoid

Some of the black hat techniques that have been tried in the past include key word stuffing:  simply adding keywords about 200 times to the bottom of a webpage. This worked until Google nixed it.   Then there were hidden key words, adding hundreds of keywords on a webpage in white on a white background—you can’t see it, but Google’s spiders can.  This worked until Google nixed it.  Next there were link farms, websites set up just to link to your page. This worked until Google nixed it.  (See a pattern developing here?)

Having all kinds of slick tricks may work for a while, until Google realizes what you are up to, which will then lead to your ranking sinking like a rock.  Google can and will penalize your site in the rankings if you violate their best practices guidelines.  Or they could even remove you from their indexing service. 

illustration of white hat and black hat

Different methods of SEO

Black hat methods are eventually figured out by Google.  Once Google finds out what you are up to, not only will the ruses fail to work, you will be punished.  Try to stick to the white hat method of SEO—develop good content that is useful to readers.

Details on White Hat Methods for Search Engine Optimization

1.  Select appropriate key words. This can be trickier than it sounds.  Brainstorming with the client is a good place to begin.  If you are working on a project, be sure to visit Google Ad Words. I believe you can still set up an account without having to purchase anything.  Use the tools to search various words that your target audience may use to find your client.  Google will give you data on how often these words are searched on Google’s search engine.

2.  Find a good online text editor with SEO optimization tools. Online webpage text editors such as Word Press offer free SEO plug-ins like SEO powered by Yoast. Or if you are writing a scientific paper, ensure that keywords are in the title, abstract, and throughout the article; a simple keyword search in your favorite text editor will suffice.

3.  Make your file names keyword rich. Include keywords in all file names, whether for text, images, or other media.  Title display in search engines is limited to first 70 characters, so keep your headlines brief and keyword rich.  Your URL (Uniform Resource Locator or website address) also needs to have keywords.  Don’t go overboard with keywords—limit yourself to 5 to 7—or Google will move you down in the rankings.

4.  Ensure a minimum of 300 words per page. If there are more than 700 words, reader frequently stop reading because it takes too long. Google gets bored with long pages, too.  Longer posts should be broken up into several pages.  Rather than present readers with a wall of text, remember to use quotation pull out, subheadings, and graphics.  [Side bar:  This article is longer than 1000 words, but since it is targeting medical writers, for whom plowing through several 5000-word papers are all in day’s work, that is fine.]

5.  Link to other sites with excellent content. I am thrilled that the Mayo Clinic webpages have such a high ranking in the Google search engine.  They are a known, trusted name in medical matters, so be sure to look for content on their site (to which you can link) that may also be of interest to your readers.  When reading on the Mayo Clinic website, I never find myself thinking “this was going along swimmingly, but now the writer is on Planet Crazy.”



Several of the words used in this article: Google, content, keyword, medical writer, search engine optimization

Word Cloud based on this article.

6.  Write with the end goal in mind: Are you publicizing your group, promoting your personal brand, or working for a client to sell products? Information is key. Be sure to inform your readers about good information they need.  Normally, medical writer generate informational web content for a general audience, like those visiting websites.  Use simpler sentence construction and terminology.

7.  Add images and other media. Good pictures, graphics, charts, cartoons, and even videos added to your pages will improve search engines rankings.  While you want the images to display with enough resolution to avoid pixelation, do not make them huge—300 by 300 pixels is a good ballpark for image size.  Smaller or larger sizes may work, too.  Remember to use keywords in the meta-information for your pictures and other media.  Get permission to use images or pay licensing fees for stock images.

8.  Content is king. Write content well, with useful information for your audience. Produce high quality content and remove any low-quality content.  Encourage sharing and commenting on your content.

9.  Maintain your website. Regularly check for broken links and either fix or remove them. Google is serious: they threatened to de-list a non-profit website for not fixing a hacking that took advantage of their excellent SEO.  Keep in mind a major redesign of a website may drastically change your search ranking.

10.  Are your SEO efforts paying off? Check your rankings once a month to show concrete measures of how well your SEO efforts are paying off.

DeeAnn Visk, PhD, is a freelance medical writer and editor. Pharmacogenetics, high throughput screening, cell culture, molecular biology, and in vitro diagnostics are her areas of expertise. DeeAnn lives in the San Diego area with her husband, kids, and two spoiled hens. You are welcome to contact her at deeannlwv@gmail.com.

© 2018 DeeAnn Visk. All rights reserved


Metabolomics integrates the effects of the environment with the effects of genetics

Metabolomics and Precision Medicine

Advancing Precision Medicine: Genomics, Metabolomics, and Clinical Trials

Monday, October 12 was the evening of an interesting talk at BIOCOM. Teresa Gallagher, founder of the San Diego Clinical Research Network (SDCRN) introduced the moderator of the event, Arnold Gelb, MD, Senior Medical Director at Halozyme. Rather than attempt to summarize all of the topics examined, the goal of this blog is to give a sampling of some of the areas discussed during the event.

Deterministic versus probabilistic genetics

The first speaker of the evening was Amalio Telenti, MD, PhD, Head of Genomics at Human Longevity, Inc. His talk touched on the ever-present nature vs. nurture debate. Do our genes determine a particular characteristic or merely influence the probability of developing that characteristic? In the world of whole genome sequencing, this can be described as deterministic versus probabilistic genetics.

In general, a deterministic trait would be something like Tay-Sachs Disease: if you have two copies of the gene for this condition, you have a better than 99% chance of developing the disease. A probabilistic trait is one with many genes that influence it, like height. Outside factors like disease and diet also affect how tall an individual grows. Hence, height is a probabilistic trait.

Telenti predicted that genomics will not revolutionize all aspects of medicine; but some medicine will be revolutionized profoundly; clinical trials will benefit the most. Genomics will be employed to stratify patient populations both before studies are commenced and after all the data is collected. Ideally genomics will be utilized to both determine who benefits from a drug and who should not take the drug.

Metabolomics combines genetics and environment

Steve Watkins, PhD, Chief Technology Officer of Metabolon spoke next.  Metabolon specializes in metabolomics, offering comprehensive measurements of small molecules such as glucose, cholesterol, cortisol, and amino acids in a CLIA-certified lab.

Metabolites reflect the integration of genetic and environmental influences on an individual.  Diseases can be prevented and diagnosed by checking on an individual’s metabolites. Response to disease treatment can be monitored by testing metabolites. Metabolomics is emerging as an effective tool in precision medicine.

Metabolomics integrates the effects of the environment with the effects of genetics

A person’s genome and environment affect their metabolome. Used with permission from Metabolon.

Watkins shared that Proceedings of the National Academy of Sciences recently published a study led by Baylor University’s Tom Caskey, MD. Caskey comprehensively tested the metbolites of many patients with no frank disease.  Metabolon’s platform spotted underlying health issues not previously noticed in the patients’ genetic data.

For example, Patient 3905 had very high levels of sorbitol and fructose, but no clinically significant mutation was reported in their genome.  Looking back at the genomic data for that individual, a mutation in the fructose pathway indicating “fructose intolerance” was discovered. This mutation had been overlooked previously. When discussing these results with the patient, the patient simply stated that fruit bothered him, so he refrained from eating it.

In the same study, Patient 3923 carried a gene for Xanthinuria type 1.  He showed no symptoms of the disease such as kidney stones, suggesting the gene was not penetrant (or not expressed), leaving the patient symptom-free.

In conclusion, Watkins stated that metabolomics can be used in a number of ways:

1)  By identifying pathways of interest for genetic assessment

2)  By revealing non-penetrance of genes suspected of being deleterious

3)  By enabling monitoring and understanding of metabolic conditions

Which drugs to use in cancer treatment?

The final speaker for the evening was Nicholas Schork, PhD Professor and Director of Human Biology at the J. Craig Venter Institute. He focused on emerging themes of design for precision medicine trials.

Schork presented several novel ideas. One was the idea of vetting algorithms for the treatment of cancers based on the mutations the cancers carry. Some hospitals already use this method, begging the question of who has the best algorithm for cancer treatment. As Schork points out, this has led to some interesting conversations with the FDA. He envisions clinical trials in the future for the evaluation of algorithms for cancer treatment with existing drugs, in direct contrast to the conventional clinical trial, usually designed to assess the effectiveness of a new drug.

In all, this was an exciting presentation of cutting-edge research and future directions in precision medicine.

Yes, these are lipids. But there are so many more inside your body; and they do more than store fat!

Annual Lipids Meeting in La Jolla California

The 2015 meeting on Lipids—focusing on their impact in cancer, metabolic, and inflammatory diseases—took place on Tuesday and Wednesday, May 12 and 13 at the Scripps Seaside Forum at UCSD’s Scripps Institute of Oceanography (SIO). With a beautiful venue and superb facilities, what more can you ask for? How about some really interesting science.

Lipids are generally thought of as fats. But in a biological system, they are much more. They include chemokines and other signaling molecules involved in signal transduction to and from the cell membrane. Metabolically, lipids also play an important role. Innovation in technology allow the study all the lipids in an organism (yeast, bacteria, or animal), leading to a new field of study: lipidomics. Once again, UCSD is on the cutting edge, with an established program and website in the field.

ocean, palm trees, La Jolla pennisula, green lawn with white chairs; breakfast view for lipids conference

View from the Scripps Seaside Forum at UCSD’s Scripps Institution of Oceanography.

Michael Snyder, the keynote speaker, has subjected himself to a battery of “omic” studies including his personal genome, exosome, microbiome, epigenome, proteome, metabolome, transcriptome, auto-antibody-ome, as well as cytokines. Data from these samples comprise the “Snyerdome”. All this was done in the interest of personalized medicine. These studies were done not only at one time point, but over a range of times, making it longitudinal.

Mike sees the data providing insights into how to managing healthcare in healthy individuals to predict risk, diagnose, monitor, and treat the patient, in this case, himself.

“He has also combined different state-of–the-art “omics” technologies to perform the first longitudinal detailed integrative personal omics profile (iPOP) of person and used this to assess disease risk and monitor disease states for personalized medicine” (from lab website).

in the future, Mike sees genomes being sequenced before birth and all this information being channeled through your smart phone. Patients will also bear more responsibility for maintaining their health with all the information they have; they will need to learn to maintain a balanced life.

The next speaker, David Wishart, discussed how to link lipidomics to laboratory medicine. He noted that in the rationalization of translating basic research to something of value in the clinic, researcher often cite the possibility of developing a new:          

  • surgical technique
  • invent a new medical device
  • drug
  • drug target
  • medically important gene
  • biomarker

All these are good outcomes; some are more likely than others. Practitioners of lipidomics are most likely to have the best luck in developing new biomarkers; not many are surgeon and drug development has about a 0.001% success rate from basic science to the prescription bottle.

lipids, lipids, lipids

Slide from David Wishart’s talk listing the number of FDA approved clinical tests from omic data

Discovery of new biomarkers is a realm where omics, specifically lipidomics, will meet a great chance of success. For this comparison, David recommends using the statistical ROC test, which is routinely used to evaluate medical test. This test gives a good sense of a medical test’s specificity and sensitivity by plotting the true positive rate over the false positive rate.

Example of ROC curve with an assessment of the area under the curve. The PSA referred to here is the amount of Prostate-Specific Antigen test; phi refers to a different, more specific calculation with less false positives than the PSA test alone.


ROC curve used to show predictive value of a test for prostate cancer using two different methods.

ROC curve used to show predictive value of a test for prostate cancer using two different methods.

Or you can just know that an ROC of 0.5 is worthless, while 1.0 is perfect.

Thus, from the graph above, using the PSA test alone to determine the risk of prostate cancer is poor. A better method is to use the phi method.

Work done looking at 3 to 5 biomarkers can have great ROC results. For example, predicting congenital heart defects by looking at the level of 3 carotenes, yields a ROC of 0.98. Other areas of success with high ROC scores include endometrial cancer, prostate cancer, and chronic fatigue syndrome.

David urged participants to become more quantitative to move their research into the clinic; using the website www.roccet.ca to generate ROC curves for your data is a great place to begin.

The numerous other speakers all gave fantastic talks.

In this smaller conference, I was able to browse through the all posters, read all the titles and talk to the presenters. Large conventions tend to lack the sense of intimacy and fraternity found in this lipidomics meeting. Kudos to the organizers for a successful event. A convivial group, I would highly recommend this meeting.


Optimizing 2D Assay Kits for Use on 3D Cultures

Assay Optimization for 3D Cultures

No, not this 3D culture

3D Movie Culture

The culture of 3D movie goers.

But this kind

3D Cultures in a tissue culture context

Tissue culture cells growing in three dimensions.

Traditionally, mammalian cell culture means living cells grown outside the body on specially treated tissue culture plates in specialized incubators. Millions (dare I say billions?) of experiments utilizing this technique leading to huge advances in research and medicine.

To improve on this convention, innovators develop cultures that grow, not just in two dimensions (2D), but three dimensions (3D). General consensus in the field now is that these 3D cultures are more physiologically relevant—closer to native whole organisms—than conventional 2D cultures.

With more use of 3D cultures in business and research, a new challenge to testing larger volumes of cells arises. Almost all previous assays used to test qualities of cells in culture have only been tested and optimized for traditional 2D models. What hurdles face scientist who want to test (assay) their cultures in 3D rather than 2D?

Terry Riss, a Promega scientist, presented his company’s findings in a talk at the Society of Toxicologist meeting on Monday, March 23, 2015 at the San Diego Convention Center. Promega’s work has been primarily conducted with spheroids generated with a hanging drop method from a company aptly named In Sphero

In thinking about differences between 2D and 3D cultures, one huge differences is the ability of reagents to diffuse longer distances into cells. Two dimensional cells tend to grow flat and spread out on the dish surface, allowing great accessibility to the innards of the cells, which scientist are obsessively interested in.

Promega offers various “Glo” assays for cell viability. Generally they are better than the usual MTT or resazurin tests in that they are less toxic to the cells and permit the same cells to be used again after the assays for even more assays (there we go again, us scientist and our obsession with assays).

In general, Riss advocates optimizing any off-the-shelf assays developed for 2D cell culture with your own particular cell line and application (basic good lab practice in my book!).

Try increasing these three parameters:

  • Detergent concentration to lysis the cells
  • Physical disruption used to dissociate the cells
  • Time of incubation

As always, remember to  include controls, both positive and negative, and optimize the experiment to your particular assay needs.

As the drug development moves towards more 3D cell culture models, the need for assays of these cultures will grow.  Promega is adding to their repertoire of kits to meet this need.